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Metaplastic Carcinoma
Jessica W. T. Leung, MD; Wei Tse Yang, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Carcinosarcoma, carcinoma with sarcomatous metaplasia, sarcomatoid carcinoma
              • Definitions

                • Heterogeneous group of neoplasms with both epithelial and mesenchymal differentiation that consists entirely or in part of 3 main categories
                  • Squamous or spindle cell, matrix-producing, and true malignant mesenchymal component (carcinosarcoma)
                  • Rare variant of invasive ductal carcinoma
                  • Despite heterogeneity within tumor, likely monoclonal origin

              IMAGING

              • General Features

                • Mammographic Findings

                  • Ultrasonographic Findings

                    • MR Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              Selected References

                                              1. Donato H et al: Imaging findings of metaplastic carcinoma of the breast with pathologic correlation. J Belg Soc Radiol. 102(1):46, 2018
                                              2. Hasdemir OA et al: Clinicopathological features of metaplastic breast carcinoma. Adv Clin Exp Med. 27(4):509-513, 2018
                                              3. Murphy BL et al: Management of the axilla in metaplastic breast carcinoma. Gland Surg. 7(2):200-206, 2018
                                              4. Ong CT et al: Metaplastic breast cancer treatment and outcomes in 2500 patients: a retrospective analysis of a national oncology database. Ann Surg Oncol. 25(8):2249-2260, 2018
                                              5. Yin H et al: Metaplastic squamous cell carcinoma of breast demonstrated on 18F-FDG PET/CT. Clin Nucl Med. 43(5):341-343, 2018
                                              6. Mituś JW et al: Metaplastic breast cancer with rapidly progressive recurrence in a young woman: case report and review of the literature. Arch Med Sci. 12(6):1384-1388, 2016
                                              7. Abouharb S et al: Metaplastic breast cancer: clinical overview and molecular aberrations for potential targeted therapy. Curr Oncol Rep. 17(3):431, 2015
                                              8. McKinnon E et al: Metaplastic carcinoma of the breast. Arch Pathol Lab Med. 139(6):819-22, 2015
                                              9. Paul Wright G et al: Hormone receptor status does not affect prognosis in metaplastic breast cancer: a population-based analysis with comparison to infiltrating ductal and lobular carcinomas. Ann Surg Oncol. 21(11):3497-503, 2014
                                              10. Ryckman EM et al: AIRP best cases in radiologic-pathologic correlation: metaplastic squamous cell carcinoma of the breast. Radiographics. 33(7):2019-24, 2013
                                              11. Choi BB et al: Metaplastic carcinoma of the breast: multimodality imaging and histopathologic assessment. Acta Radiol. 53(1):5-11, 2012
                                              12. Lee H et al: Metaplastic breast cancer: clinicopathological features and its prognosis. J Clin Pathol. 65(5):441-6, 2012
                                              13. Rungta S et al: Metaplastic carcinomas of the breast: diagnostic challenges and new translational insights. Arch Pathol Lab Med. 136(8):896-900, 2012
                                              14. Yoo JL et al: Can MR Imaging contribute in characterizing well-circumscribed breast carcinomas? Radiographics. 30(6):1689-702, 2010
                                              15. Luini A et al: Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: the experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat. 101(3):349-53, 2007
                                              16. Shin HJ et al: Imaging features of metaplastic carcinoma with chondroid differentiation of the breast. AJR Am J Roentgenol. 188(3):691-6, 2007
                                              17. Yang WT et al: Imaging differences in metaplastic and invasive ductal carcinomas of the breast. AJR Am J Roentgenol. 189(6):1288-93, 2007
                                              18. Beatty JD et al: Metaplastic breast cancer: clinical significance. Am J Surg. 191(5):657-64, 2006
                                              19. Carter MR et al: Spindle cell (sarcomatoid) carcinoma of the breast: a clinicopathologic and immunohistochemical analysis of 29 cases. Am J Surg Pathol. 30(3):300-9, 2006
                                              20. Dave G et al: Metaplastic carcinoma of the breast: a retrospective review. Int J Radiat Oncol Biol Phys. 64(3):771-5, 2006
                                              21. Tse GM et al: Metaplastic carcinoma of the breast: a clinicopathological review. J Clin Pathol. 59(10):1079-83, 2006
                                              22. Tse GM et al: p63 is useful in the diagnosis of mammary metaplastic carcinomas. Pathology. 38(1):16-20, 2006
                                              23. Gibson GR et al: Metaplastic breast cancer: clinical features and outcomes. Am Surg. 71(9):725-30, 2005
                                              24. Velasco M et al: MRI of metaplastic carcinoma of the breast. AJR Am J Roentgenol. 184(4):1274-8, 2005
                                              25. Günhan-Bilgen I et al: Metaplastic carcinoma of the breast: clinical, mammographic, and sonographic findings with histopathologic correlation. AJR Am J Roentgenol. 178(6):1421-5, 2002
                                              26. Kurian KM et al: Sarcomatoid/metaplastic carcinoma of the breast: a clinicopathological study of 12 cases. Histopathology. 40(1):58-64, 2002
                                              27. Sneige N et al: Low-grade (fibromatosis-like) spindle cell carcinoma of the breast. Am J Surg Pathol. 25(8):1009-16, 2001
                                              28. Park JM et al: Metaplastic carcinoma of the breast: mammographic and sonographic findings. J Clin Ultrasound. 28(4):179-86, 2000
                                              29. Gobbi H et al: Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence. Cancer. 85(10):2170-82, 1999
                                              30. Rayson D et al: Metaplastic breast cancer: prognosis and response to systemic therapy. Ann Oncol. 10(4):413-9, 1999
                                              31. Brenner RJ et al: Metaplastic carcinoma of the breast: report of three cases. Cancer. 82(6):1082-7, 1998
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Carcinosarcoma, carcinoma with sarcomatous metaplasia, sarcomatoid carcinoma
                                                          • Definitions

                                                            • Heterogeneous group of neoplasms with both epithelial and mesenchymal differentiation that consists entirely or in part of 3 main categories
                                                              • Squamous or spindle cell, matrix-producing, and true malignant mesenchymal component (carcinosarcoma)
                                                              • Rare variant of invasive ductal carcinoma
                                                              • Despite heterogeneity within tumor, likely monoclonal origin

                                                          IMAGING

                                                          • General Features

                                                            • Mammographic Findings

                                                              • Ultrasonographic Findings

                                                                • MR Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          Selected References

                                                                                          1. Donato H et al: Imaging findings of metaplastic carcinoma of the breast with pathologic correlation. J Belg Soc Radiol. 102(1):46, 2018
                                                                                          2. Hasdemir OA et al: Clinicopathological features of metaplastic breast carcinoma. Adv Clin Exp Med. 27(4):509-513, 2018
                                                                                          3. Murphy BL et al: Management of the axilla in metaplastic breast carcinoma. Gland Surg. 7(2):200-206, 2018
                                                                                          4. Ong CT et al: Metaplastic breast cancer treatment and outcomes in 2500 patients: a retrospective analysis of a national oncology database. Ann Surg Oncol. 25(8):2249-2260, 2018
                                                                                          5. Yin H et al: Metaplastic squamous cell carcinoma of breast demonstrated on 18F-FDG PET/CT. Clin Nucl Med. 43(5):341-343, 2018
                                                                                          6. Mituś JW et al: Metaplastic breast cancer with rapidly progressive recurrence in a young woman: case report and review of the literature. Arch Med Sci. 12(6):1384-1388, 2016
                                                                                          7. Abouharb S et al: Metaplastic breast cancer: clinical overview and molecular aberrations for potential targeted therapy. Curr Oncol Rep. 17(3):431, 2015
                                                                                          8. McKinnon E et al: Metaplastic carcinoma of the breast. Arch Pathol Lab Med. 139(6):819-22, 2015
                                                                                          9. Paul Wright G et al: Hormone receptor status does not affect prognosis in metaplastic breast cancer: a population-based analysis with comparison to infiltrating ductal and lobular carcinomas. Ann Surg Oncol. 21(11):3497-503, 2014
                                                                                          10. Ryckman EM et al: AIRP best cases in radiologic-pathologic correlation: metaplastic squamous cell carcinoma of the breast. Radiographics. 33(7):2019-24, 2013
                                                                                          11. Choi BB et al: Metaplastic carcinoma of the breast: multimodality imaging and histopathologic assessment. Acta Radiol. 53(1):5-11, 2012
                                                                                          12. Lee H et al: Metaplastic breast cancer: clinicopathological features and its prognosis. J Clin Pathol. 65(5):441-6, 2012
                                                                                          13. Rungta S et al: Metaplastic carcinomas of the breast: diagnostic challenges and new translational insights. Arch Pathol Lab Med. 136(8):896-900, 2012
                                                                                          14. Yoo JL et al: Can MR Imaging contribute in characterizing well-circumscribed breast carcinomas? Radiographics. 30(6):1689-702, 2010
                                                                                          15. Luini A et al: Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: the experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat. 101(3):349-53, 2007
                                                                                          16. Shin HJ et al: Imaging features of metaplastic carcinoma with chondroid differentiation of the breast. AJR Am J Roentgenol. 188(3):691-6, 2007
                                                                                          17. Yang WT et al: Imaging differences in metaplastic and invasive ductal carcinomas of the breast. AJR Am J Roentgenol. 189(6):1288-93, 2007
                                                                                          18. Beatty JD et al: Metaplastic breast cancer: clinical significance. Am J Surg. 191(5):657-64, 2006
                                                                                          19. Carter MR et al: Spindle cell (sarcomatoid) carcinoma of the breast: a clinicopathologic and immunohistochemical analysis of 29 cases. Am J Surg Pathol. 30(3):300-9, 2006
                                                                                          20. Dave G et al: Metaplastic carcinoma of the breast: a retrospective review. Int J Radiat Oncol Biol Phys. 64(3):771-5, 2006
                                                                                          21. Tse GM et al: Metaplastic carcinoma of the breast: a clinicopathological review. J Clin Pathol. 59(10):1079-83, 2006
                                                                                          22. Tse GM et al: p63 is useful in the diagnosis of mammary metaplastic carcinomas. Pathology. 38(1):16-20, 2006
                                                                                          23. Gibson GR et al: Metaplastic breast cancer: clinical features and outcomes. Am Surg. 71(9):725-30, 2005
                                                                                          24. Velasco M et al: MRI of metaplastic carcinoma of the breast. AJR Am J Roentgenol. 184(4):1274-8, 2005
                                                                                          25. Günhan-Bilgen I et al: Metaplastic carcinoma of the breast: clinical, mammographic, and sonographic findings with histopathologic correlation. AJR Am J Roentgenol. 178(6):1421-5, 2002
                                                                                          26. Kurian KM et al: Sarcomatoid/metaplastic carcinoma of the breast: a clinicopathological study of 12 cases. Histopathology. 40(1):58-64, 2002
                                                                                          27. Sneige N et al: Low-grade (fibromatosis-like) spindle cell carcinoma of the breast. Am J Surg Pathol. 25(8):1009-16, 2001
                                                                                          28. Park JM et al: Metaplastic carcinoma of the breast: mammographic and sonographic findings. J Clin Ultrasound. 28(4):179-86, 2000
                                                                                          29. Gobbi H et al: Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence. Cancer. 85(10):2170-82, 1999
                                                                                          30. Rayson D et al: Metaplastic breast cancer: prognosis and response to systemic therapy. Ann Oncol. 10(4):413-9, 1999
                                                                                          31. Brenner RJ et al: Metaplastic carcinoma of the breast: report of three cases. Cancer. 82(6):1082-7, 1998